Eur J Pediatr Surg 2018; 28(03): 293-296
DOI: 10.1055/s-0037-1603526
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Feeding Jejunostomy: Is It a Safe Route in Pediatric Patients? Single Institution Experience

Francesco Fascetti-Leon
Pediatric Surgery, Department of Women's and Children's Health, University of Padua, Padova, Italy
Department of Pediatric Surgery, Chelsea and Westminster Hospital, NHS Foundation Trust, London, United Kingdom
,
Hisham El Agami
Department of Pediatric Surgery, Chelsea and Westminster Hospital, NHS Foundation Trust, London, United Kingdom
,
Dalia Gobbi
Department of Pediatric Surgery, Ospedale Cà Foncello, Treviso, Italy
,
Simon Clarke
Department of Pediatric Surgery, Chelsea and Westminster Hospital, NHS Foundation Trust, London, United Kingdom
,
Munther Haddad
Department of Pediatric Surgery, Chelsea and Westminster Hospital, NHS Foundation Trust, London, United Kingdom
,
Muhammad Choudhry
Department of Pediatric Surgery, Chelsea and Westminster Hospital, NHS Foundation Trust, London, United Kingdom
› Author Affiliations
Funding None.
Further Information

Publication History

29 January 2017

18 April 2017

Publication Date:
23 May 2017 (eFirst)

Abstract

Introduction Impossibility to place a gastrostomy and failed gastroesophageal reflux surgery with unsafe swallow are the main indications to Feeding Jejunostomy (FJ) in children. The aim of this study is to quantify the incidence of complications associated with FJ.

Materials and Methods A retrospective review of patients who had surgically inserted FJ between January 2009 and August 2013 at our institution was conducted. Data were obtained from medical records, operative notes, and radiology database, focusing on complications.

Results A total of 19 patients, average age 39.6 months (3–168 months), were treated during the study period. Indications to FJ were gastroesophageal reflux disease (GERD) associated with unsafe swallow in 12, esophageal atresia in 5, and foregut dysmotility in 2. Seventeen FJ were inserted via laparotomy and 2 were laparoscopically assisted. In all cases, a serosal tunnel on the antimesenteric border was fashioned. No intraoperative complications were recorded. Tube dislodgement/blockage occurred on an average of 0.48 times per month in 18 out of 19 patients. The average radiation dose received for tube reinsertion/manipulation was 3.316 mSv/year/patient (0–10.66). Major postoperative complications occurred in 7 out of 19. After an average follow-up of 21 months, two have abandoned the use of FJ due to poor tolerance and three have fully weaned off. Two patients died due to unrelated causes.

Conclusion FJ, as an alternative means for enteral feeding, may require multiple readmissions and exposure to radiological procedures. The high risk of severe complications should be considered when offering this procedure.